Table 2. Use of Outpatient and Primary Care Services, Emergency Departments, and Hospitalizations During Months 3 to 12 Post Partum Among Individuals with Medicaid-Financed Births Continuously Enrolled in Medicaid vs Commercial Insurancea.
| Variable | Medicaid enrollment | Commercial enrollment | Unadjusted difference (95% CI) | Adjusted difference (95% CI)b |
|---|---|---|---|---|
| No. of births | 42 989 | 1482 | NA | NA |
| Patients with any health care use, No. (%) | ||||
| Outpatient visits | 31 683 (73.7) | 1175 (79.3) | 5.65 (3.54 to 7.76) | 7.12 (6.39 to 7.84) |
| Primary care visits | 4944 (11.5) | 218 (14.7) | 3.20 (1.38 to 5.03) | 2.46 (2.12 to 2.79) |
| ED visits | 12 080 (28.1) | 298 (20.1) | −8.00 (−10.09 to −5.92) | −7.92 (−8.44 to −7.40) |
| Hospitalizations | 731 (1.7) | 12 (0.8) | −0.91 (−1.38 to −0.43) | −0.48 (−0.51 to −0.45) |
| Mean health care use, No. | ||||
| Outpatient visits | 6.65 | 6.50 | −0.15 (−0.59 to 0.29) | 0.16 (0.10 to 0.22) |
| Primary care visits | 0.18 | 0.32 | 0.14 (0.07 to 0.21) | 0.81 (0.70 to 0.92) |
| ED visits | 0.59 | 0.40 | −0.19 (−0.25 to −0.13) | −0.14 (−0.24 to −0.04) |
| Hospitalizations | 0.02 | 0.01 | −0.01 (−0.01 to −0.00) | −0.40 (−0.91 to 0.10) |
| Mean total spending per person, $ | ||||
| Total costs | 4207 | 4715 | 508 (−133 to 1149) | 1110 (509 to 1710) |
| Outpatient visits | 1952 | 2206 | 254 (−127 to 634) | 360 (21 to 699) |
| Primary care visits | 40 | 61 | 21 (3 to 45) | 29 (7 to 51) |
| ED visits | 1433 | 2137 | 704 (255 to 1154) | 1086 (805 to 1367) |
| Hospitalizations | 710 | 300 | −410 (−606 to −215) | −309 (−638 to 19) |
| Mean out-of-pocket spending per person, $ | ||||
| Total out-of-pocket | 18 | 801 | 783 (620 to 946) | 796 (754 to 838) |
| Outpatient visits | 8 | 370 | 361 (270 to 452) | 362 (341 to 383) |
| Primary care visits | 0.12 | 5 | 5 (3 to 8) | 5 (5 to 6) |
| ED visits | 6 | 381 | 375 (259 to 492) | 387 (359 to 415) |
| Hospitalizations | 4 | 36 | 32 (−30 to 95) | 34 (15 to 54) |
Abbreviation: ED, emergency department.
Spending is measured in 2020 US dollars, inflated using the medical care services component of the consumer price index. Health care use variables are measured as a binary outcome for any visit of that type during the 3 to 12 months post partum and in counts (at the visit level). Spending measures (total and out of pocket) are reported as unconditional per person averages during the 3- to 12-month period. Sample is trimmed with the top 1% of individuals with the highest levels of billed spending removed. Billed spending measures the sum of insurer and consumer payments.
The adjusted differences column reports regression-adjusted coefficients and 95% confidence intervals for each variable. Each coefficient is the estimated coefficient on the treatment dummy (where 1 = continuously enrolled in commercial; 0 = continuously enrolled in Medicaid). Regression covariates include all covariates in Table 1 and year fixed effects. Models are estimated using Newton-Raphson methods (using the glm command in Stata [StataCorp]) with a logit link for use likelihood, a negative binomial distribution, and a log link for use outcomes and a gaussian distribution for spending outcomes.